Craig A Field1, Gerald Cochran, Raul Caetano, Michael Foreman, Carlos V R Brown. 1. From the University of Texas at Austin (C.A.F.); and University Medical Center at Brackenridge (C.V.R.B.), Austin; and University of Texas School of Public Health and University of Texas Southwestern Medical Center (R.C.); and Baylor University Medical Center (M.F.), Dallas, Texas; University of Pittsburgh (G.C.), Pittsburgh, Pennsylvania.
Abstract
BACKGROUND: Nonmedical use of prescription opioids (NM-POs) has reached epidemic proportions in the United States. Unintentional overdose deaths involving prescription opioids have quadrupled since 1999. Herein, we examine NM-POs and their associated risk factors among two cohorts of trauma patients with at-risk drinking. METHODS: This secondary analysis examines NM-PO from two separate randomized trials that delivered brief alcohol interventions to patients in urban Level I trauma centers. In the first study, data were collected from 1,493 injured patients at a single trauma center, and in the second study, data were collected from 596 injured patients at two trauma centers. All participants were considered at-risk drinkers because they were admitted for an alcohol related injury as indicated by a positive blood alcohol concentration and/or self-reported heavy drinking. RESULTS: In Study 1, NM-PO nearly doubled from 5.2% before admission to 9.8% at 6 months after discharge. At 12 months after discharge, those who reported NM-PO (odds ratio [OR], 2.31; 95% confidence interval [CI], 1.28-4.15) and drug use (OR, 2.62, 95% CI, 1.70-4.04) before admission had the highest odds for postdischarge NM-PO. In Study 2, NM-PO increased from 5.2% before admission to 6.8% at 12 months after discharge. At 12 months after discharge, those who reported NM-PO (OR, 2.71; 95% CI, 1.10-6.66) or drug use (OR, 4.05; 95% CI, 2.00-8.21) before admission had the highest odds for postdischarge NM-PO. CONCLUSION: The results suggest that there is an increased risk of postdischarge NM-PO among injured patients with at-risk drinking, particularly among those with a recent history of drug use or NM-PO. Cautious, evidence-based opioid prescribing may reduce exposure to prescription opioids in high-risk patients, risk of subsequent misuse, and possible diversion. LEVEL OF EVIDENCE: Prognostic/epidemiologic study, level II.
RCT Entities:
BACKGROUND: Nonmedical use of prescription opioids (NM-POs) has reached epidemic proportions in the United States. Unintentional overdose deaths involving prescription opioids have quadrupled since 1999. Herein, we examine NM-POs and their associated risk factors among two cohorts of traumapatients with at-risk drinking. METHODS: This secondary analysis examines NM-PO from two separate randomized trials that delivered brief alcohol interventions to patients in urban Level I trauma centers. In the first study, data were collected from 1,493 injured patients at a single trauma center, and in the second study, data were collected from 596 injured patients at two trauma centers. All participants were considered at-risk drinkers because they were admitted for an alcohol related injury as indicated by a positive blood alcohol concentration and/or self-reported heavy drinking. RESULTS: In Study 1, NM-PO nearly doubled from 5.2% before admission to 9.8% at 6 months after discharge. At 12 months after discharge, those who reported NM-PO (odds ratio [OR], 2.31; 95% confidence interval [CI], 1.28-4.15) and drug use (OR, 2.62, 95% CI, 1.70-4.04) before admission had the highest odds for postdischarge NM-PO. In Study 2, NM-PO increased from 5.2% before admission to 6.8% at 12 months after discharge. At 12 months after discharge, those who reported NM-PO (OR, 2.71; 95% CI, 1.10-6.66) or drug use (OR, 4.05; 95% CI, 2.00-8.21) before admission had the highest odds for postdischarge NM-PO. CONCLUSION: The results suggest that there is an increased risk of postdischarge NM-PO among injured patients with at-risk drinking, particularly among those with a recent history of drug use or NM-PO. Cautious, evidence-based opioid prescribing may reduce exposure to prescription opioids in high-risk patients, risk of subsequent misuse, and possible diversion. LEVEL OF EVIDENCE: Prognostic/epidemiologic study, level II.
Authors: Janette Baird; Mark Faul; Traci C Green; Jonathan Howland; Charles A Adams; Melinda J Hodne; Nie Bohlen; Michael J Mello Journal: J Trauma Nurs Date: 2019 May/Jun Impact factor: 1.010
Authors: Jannette Baird; Mark Faul; Traci C Green; Jonathan Howland; Charles A Adams; Ann George; Michael J Mello Journal: Drug Alcohol Depend Date: 2017-06-13 Impact factor: 4.492
Authors: Luana Colloca; Ariana Taj; Rachel Massalee; Nathaniel R Haycock; Robert Scott Murray; Yang Wang; Eric McDaniel; Thomas M Scalea; Yvette Fouche-Weber; Sarah Murthi Journal: Front Psychiatry Date: 2022-07-04 Impact factor: 5.435
Authors: Randall Brown; Brienna Deyo; Chelsea Riley; Andrew Quanbeck; Joseph E Glass; Rebecca Turpin; Scott Hetzel; Christopher Nicholas; Maireni Cruz; Suresh Agarwal Journal: Addict Sci Clin Pract Date: 2017-12-04